Article

The main determinants of prosthetic use known from literature apply
to the younger patient with lower limb amputation. Studies aimed at identifying
determinants of outcome of lower limb amputation in elderly patients with
multimorbidity that rehabilitate in skilled nursing facilities (SNFs) are scarce.
OBJECTIVES: To predict prosthetic use and physical mobility in geriatric patients
admitted to SNFs for rehabilitation after lower limb amputation and the impact of
multimorbidity. STUDY DESIGN: Prospective design. METHODS: Univariate and
multivariate logistic and linear regression analyses were used to identify
determinants that were independently related to prosthetic use and the
timed-up-and-go test (TUG test). RESULTS: Of 55 eligible patients, 38 had
complete assessments on admission and at discharge. Fifty per cent was provided
with a prosthesis. Multimorbidity was present in 53% of the patients. Being able
to ambulate independently, and having a transtibial amputation (rather than a
higher level of amputation), without phantom pain determined prosthetic use
(R(2)=56%), while cognitive abilities, low amputation level, and pre-operative
functional abilities were independently associated with the TUG test (R(2)=82%).
CONCLUSIONS: Elderly patients referred to an SNF for prosthetic training have a
high probability of using a prosthesis when having an independent ambulation
after transtibial amputation, without phantom pain. These patients should be
considered for prosthetic training.

Langue : ANGLAIS